Clinical Practice Guidelines | Texas Children's Health Plan

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Clinical Practice Guidelines

Below you will find all of the Clinical Practice Guidelines. If you wish to open the following forms, you must have Adobe Acrobat Reader installed on your computer. To download a form, right click on one of the links below and select "Save Target As."
To download a free copy of Adobe Acrobat Reader, click here.

Availability of Criteria

The criteria which is used to make an authorization decision is available to the practitioner over the phone or made available in our office for proprietary criteria. Criteria used from the public domain is facilitated through a URL link or a mailed copy.
Providers requesting the criteria by phone should call Provider Relations at 832-828-1004 and request the Utilization Review manager.

Allergy Guidelines


Asthma Guidelines


Behavioral Health Guidelines



Addiction Medicine






State guidelines – Screening and Drug Formulary


Diabetes Guidelines


Neuropsychology Guidelines


Otitis Guidelines


Obesity Guidelines


Pharyngitis Guidelines


Preventative Guidelines